Surgical management of uterine fibroids in a tertiary hospital in south‑west Nigeria
Context: Symptomatic uterine fibroids are frequently encountered in gynecological practice in black populations. An evaluation of the surgical management is in order to audit practice, highlight complications, and facilitate care.
Aims: This study aimed to evaluate morbidity following abdominal myomectomy and hysterectomy for symptomatic uterine fibroids.
Settings and Design: A cross‑sectional study retrospectively reviewing cases of symptomatic uterine fibroids that were
managed surgically at a tertiary hospital in south‑west Nigeria.
Methods and Material: Surgeries performed over a five‑year period were retrieved from the gynecological theatre of the hospital. The case notes were retrieved and information on socio‑demographic, perioperative and postoperative characteristics was obtained.
Statistical analysis used: Chi‑square tests and Student’s‑t tests were performed to evaluate categorical and continuous variables, respectively. Significant P was set at < 0.05.
Results: Of 214 eligible cases, 79 (36.9%) had hysterectomy and 135 (63.1%) had myomectomy. No other surgical treatment methods were employed. Age was the only significant socio‑demographic feature; younger women were more likely to have myomectomy (P < 0.001). Mean blood loss and transfusion rates were comparable between the two groups. Complications included hemorrhage in 36.0%, wound infection in 4.7%, and postoperative fever in 1.9%. There were no conversions of myomectomy to hysterectomy and no mortalities. There was no significant difference in the prevalence of complications in either surgery group.
Conclusions: Apart from hemorrhage, morbidities were few in this series. Gynecologists should ensure adequate preparations to control blood loss before and during fibroid surgery.
Key words: Fibroids; hemorrhage; hysterectomy; myomectomy.
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